• 대한세포병리학회지
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• 제5권1호
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• pp.52-56
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• 1994

We experienced a case of fine-needle aspiration (FNA) cytology of breast which showed atypical proliferative lesion. It was very difficult to differentiate this case from malignancy, because of hypercellular smear and many clusters composed of large, atypical ductal cells. However, it showed other features favoring benignancy, such as tendency of cellular cohesiveness, only slightly increased nucleus/cytoplasm ratio and most importantly presence of myoepithelial cells. It's histologic diagnosis was intraductal hyperplasia with atypia. This case indicates that all atypical breast FNA specimen should lead to the suggestion of surgical biopsy for avoiding over- or under-diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3733-3736
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• 2016

HER2/neu is a well-established prognostic and predictive factor for invasive breast cancer. However, the role of HER2/neu in ductal breast carcinoma in situ (DCIS) is debated and recent data have suggested that it is mainly linked to in situ local recurrence. Although molecular data suggest that atypical ductal hyperplasia (ADH) and duct carcinoma in situ (DCIS) are related lesions, albeit with vastly different clinical implications, the role of HER2/neu expression in atypical ductal hyperplasia is not well defined either. The aim of this study was to evaluate over expression of HER2/neu in DCIS and cases of ADH in comparison with invasive breast carcinoma. Archival primary breast carcinoma paraffin blocks (n=15), DCIS only (n=10) and ductal epithelial hyperplasia and other breast benign lesions (n=25) were analyzed for HER2/neu immunoexpression. Follow up was available for 40% of the patients. HER2/neu was positive in 80%of both DCIS and invasive carcinoma, and 67% of atypical ductal hyperplasia (ADH) cases. Thus at least a subset of patients with preinvasive breast lesions were positive, which strongly suggests a role for Her2/neu in identifying high-risk patients for malignant transformation. Although these are preliminary data, which need further studies of gene amplification within these patients as well as a larger patient cohort with longer periods of follow up, they support the implementation of routine Her2/neu testing in patients diagnosed as pure DCIS and in florid ADH.

• 대한한방부인과학회지
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• 제33권1호
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• pp.36-58
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• 2020

Objectives: We conducted a literature study on the treatment trends in China to find out the possibility of Oriental medicine treatment of atypical hyperplasia of breast (AHB). Methods: RCTs (randomized controlled trial) on AHB were collected from CNKI (China National Knowledge Infrastructure). The search words were "乳腺增生", "乳腺囊性增生", "乳癖", "中医", "中药" and "中西医结合". The search period was limited from July 2006 to May 2017. Finally, we selected 107 RCTs which were clinical studies to find out the effectiveness of Chinese herbal medicine in comparison with Western medicine. After reviewing, we investigated Chinese herbal medication guide, Chinese treatment method and prescriptions. And the correlation between the treatments and the medicinal herbs was investigated to be useful in the clinical practice. Results: 1. The administration of herbal medicine was 58.9 percent in 63 cases, followed by menstrual cycles, and 41.1 percent in 44 cases, regardless of menstrual cycles. 2. In the basic frequency analysis between the treatment and the medicinal herb, the frequency of dissipate binds (散結) was the highest. Next, there was a high frequency of therapies such as activating blood-activating (活血), relieve pain (止痛), soothe the liver (疏肝), regulate qi (理氣), resolve phlegm (化痰), soften hardness (軟堅), resolve depression (解鬱), move qi (行氣) of frequency was high. In herbal medicine, bupleuri radix (柴胡), cyperi rhizoma (香附子), angelicae gigantis radix (當歸), fritillaria thunbergii bulb (貝母), paeoniae radix alba (白芍藥), prunellae spica (夏枯草), corydalis rhizoma (玄胡索) showed high frequency. 3. We finded out the correlation between the frequent treatment methods and the medicinal herbs using Text Mining. Conclusions: These findings are thought to help implement Korean traditional medicine treatments for AHB.

• 대한영상의학회지
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• 제81권6호
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• pp.1504-1510
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• 2020

이 증례 보고는, 남성 유방에서의 비정형유관증식증 소견에 대한 영상의학적, 병리학적 소견을 담고 있다. 비정형유관증식증은 고위험 병변에 속하며 유방암의 전구 병변으로 잘 알려져 있다. 하지만, 이런 병변이 남성 유방에서 어떠한 임상적 의미를 갖는지는 잘 알려져 있지 않다. 남성 유방은 여성 유방과 달리 유관이 소엽을 구성하지 않기 때문이다. 지금까지 이러한 전구 병변의 영상 소견과 병리학적 소견을 다룬 문헌은 극소수이다. 이 증례 보고를 통해, 우리는 남성 유방에서 유방암 전구 병변의 가능한 영상 및 병리 소견을 제시하고, 문헌고찰을 하고자 한다.

• Korean Journal of Radiology
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• 제21권11호
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• pp.1220-1229
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• 2020

Objective: Stereotactic vacuum-assisted breast biopsy (VABB) is considered a reliable alternative to surgical biopsy for suspicious calcifications. In most cases, the management of flat epithelial atypia (FEA) and atypical ductal hyperplasia (ADH) after VABB with residual calcifications requires surgical excision. This study aimed to evaluate the impact of pathology of non-calcified specimens on the underestimation of malignancy. Materials and Methods: We retrospectively reviewed 1147 consecutive cases of stereotactic VABB of suspicious calcifications without mass from January 2010 to December 2016 and identified 46 (4.0%) FEA and 52 (4.5%) ADH cases that were surgically excised for the retrieval of residual calcifications. Mammographic features and pathology of the calcified and non-calcified specimens were reviewed. Results: Seventeen specimens (17.3%) were upgraded to malignancy. Mammographic features associated with the underestimation of malignancy were calcification extent (> 34.5 mm: odds ratio = 6.059, p = 0.026). According to the pathology of calcified versus non-calcified specimens, four risk groups were identified: Group A (ADH vs. high-risk lesions), Group B (ADH vs. non-high-risk lesions), Group C (FEA vs. high-risk lesions), and Group D (FEA vs. non-high-risk lesions). The lowest underestimation rate was observed in Group D (Group A vs. Group B vs. Group C vs. Group D: 35.0% vs. 20.0% vs. 15.0% vs. 3.6%, p = 0.041, respectively). Conclusion: Considering that the calcification extent and pathology of non-calcified specimens may be beneficial in determining the likelihood of malignancy underestimation, excision after FEA or ADH diagnosis by VABB is required, except for the diagnoses of FEA coexisting without atypia lesions in non-calcified specimens.

• 대한세포병리학회지
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• 제5권2호
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• pp.106-112
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• 1994

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for fine needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five fine needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition, these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2385-2392
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• 2012

The lack of effective treatment targets for triple-negative breast cancers make them unfitted for endocrine or HER2 targeted therapy, and their prognosis is poor. Transcription factor ER81, a downstream gene of the HER2, is highly expressed in breast cancer lines, breast atypical hyperplasia and primary breast cancers including triple-negative examples. However, whether and how ER81 affects breast cancer carcinogenesis have remained elusive. We here assessed influence on a triple-negative cell line. ER81-shRNA was employed to silence ER81 expression in the MDA-MB-231 cell line, and MTT, colony-forming assays, and flow cytometry were used to detect cell proliferation, colony-forming capability, cell cycle distribution, and cell apoptosis in vitro. MDA-MB-231 cells stably transfected with ER81-shRNA were inoculated into nude mice, and growth inhibition of the cells was observed in vivo. We found that ER81 mRNA and protein expression in MDA-MB-231 cells was noticeably reduced by ER81-shRNA, and that cell proliferation and clonality were decreased significantly. ER81-shRNA further increased cell apoptosis and the residence time in $G_0/G_1$ phase, while delaying tumor-formation and growth rate in nude mice. It is concluded that ER81 may play an important role in the progression of breast cancer and may be a potentially valuable target for therapy, especially for triple negative breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3179-3183
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• 2014

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

• 대한영상의학회지
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• 제83권3호
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• pp.632-644
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• 2022

목적 조직생검으로 진단된 비정형 관상피증식증이 수술 후 악성으로 진단되는 과소평가율과 이를 예측할 수 있는 영상 소견이나 진단 방법에 따른 위험인자를 조사하고자 한다. 대상과 방법 2년 이상의 기간 동안 시행된 9660예의 침생검을 후향적으로 분석하여 영상 소견과 조직검사 방법에 따라 과소평가 군과 비 과소평가 군의 차이점을 비교하였다. 결과 9660예의 침생검 중 169 (1.7%)예가 비정형 관상피증식증으로 진단되었다. 절제 생검을 한 112예와 2년 이상 추적검사를 한 30예를 합친 142예 중 35예에서 과소평가되었다 (24.6%, 35/142). 과소평가율의 차이는 조직생검 방법에 따라 의미 있었다; 초음파 유도 핵생검(40.7%, 22/54), 입체정위 진공 보조흡입생검(16.0%, 12/75), 초음파 유도 진공 보조흡입생검 (7.7%, 1/13) (p = 0.002). 다변량 분석에서는 초음파 유도 핵생검(교차비 5.19, 95% 신뢰구간 2.16-13.95, p < 0.001)이 독립적인 위험 인자였다. 종괴로 보이는 병변이 초음파 유도 진공 보조흡입생검으로 진단된 경우는 과소평가가 보고되지 않았다( n = 7). 결론 비정형 관상피증식증이 1.7%로 진단되었고 과소평가율은 24.6%였다. 종괴로 보이는 병변이 초음파 유도 진공 보조흡입생검으로 제거된 경우를 제외하고는 상당한 과소평가율을 보이고 있으므로 수술적 절제를 고려해야 한다.

• 대한핵의학회지
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• 제33권1호
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• pp.76-83
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• 1999

목적: 유방종괴의 악성과 양성을 구별하는 데 사용되고 있는 탈륨스캔의 조기스캔 및 지연스캔과 함께 Tc-99m MIBI 스캔을 시행하여 이들을 비교하였다. 대상 및 방법: 유방종괴를 호소한 환자 38명을 대상으로 탈륨의 조기스캔과 지연스캔 및 Tc-99m MIBI 스캔을 얻었다. 탈륨스캔은 74-111 MBq의 탈륨을 정맥주사한 후 10분과 3시간에 촬영을 하고, 이어서 555-740 MBq의 Tc-99m MIBI를 정맥주사하고 30분 후에 전면상과 측면상을 얻어 서로 비교하였다. 결과: 38명의 환자 중 23예가 악성 종양으로, 15예가 양성 종양이었다. 유방암 진단의 민감도와 특이도는 탈륨 조기스캔이 100% (23/23)와 73% (11/15), 탈륨 지연스캔이 82% (18/22)와 73% (l1/15), Tc-99m MIBI 스캔이 90% (18/20)와 83% (10/12)로서 탈륨 조기스캔의 민감도가 탈륨 지연스캔보다 유의하게 높았으나(p<0.05), 다른 지표의 유의한 차이는 없었다. 탈륨 조기스캔과 지연스캔에서 위양성을 보인 섬유선종 3예와 비정형 상피세포증식증 1예의 종괴의 크기는 음성으르 나온 11예의 양성 종양보다 유의하게 컸다(p<0.01). 액와부 림프절 전이의 진단적 민감도는 탈륨 조기스캔이 38% (5/13), 탈륨 지연스캔이 15% (2/13), Tc-99m MIBI 평면스캔이 58% (7/12), 단층영상이 67% (4/6)였다. Tc-99m MIBl 평면, 단층영상이 탈륨 지연스캔보다 높았다. 결론: 유방암 진단에서 탈륨의 조기스캔과 Tc-99m MIBI스캔은 진단능에서 차이가 없었으나 탈륨 지연스캔은 민감도가 낮았다. 액와부 림프절 전이의 진단에는 탈륨스캔보다 Tc-99m MIBI 스캔이 우수하였다.